MEDICARE: BETHANY ARGENIO LICSW LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1669120341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETHANY ARGENIO LICSW LLC

Provider Business Mailing Address
First Line	:	1 WASHINGTON MALL # 1148
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02108-2616
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 WASHINGTON MALL # 1148
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02108-2616
Country	:	US
Telephone Number	:	857-201-0148
Fax Number	:

Authorized Official
Title or Position	:	SOCIAL WORKER
Name	:	BETHANY ARGENIO
Credential	:	LISCW
Telephone Number	:	857-201-0148

Provider Enumeration Date	:	03/12/2022
Last Update Date	:	10/17/2022

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